Mark J Coglianese, MPT | |
217 N 2nd E, Rexburg, ID 83440-1621 | |
(208) 359-6127 | |
(208) 359-6127 |
Full Name | Mark J Coglianese |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 26 Years |
Location | 217 N 2nd E, Rexburg, Idaho |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912912791 | NPI | - | NPPES |
1912912791 | Medicaid | ID | |
1912912791 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 1375 (Nevada) | Secondary |
225100000X | Physical Therapist | PT-2916 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Spine And Sport Pysical Therapy Pc | 5799772380 | 4 |
Provider Name | Spine And Sport Pysical Therapy Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1992975825 PECOS PAC ID: 5799772380 Enrollment ID: O20040427000396 |
Mailing Address | Practice Location Address |
---|---|
Mark J Coglianese, MPT 544 Golden Willow Dr, Rexburg, ID 83440-5270 Ph: (084) 031-5052 | Mark J Coglianese, MPT 217 N 2nd E, Rexburg, ID 83440-1621 Ph: (208) 359-6127 |
Jakob Carstens, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Clark Dabell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Cordell Pickering, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 526 First American Cir Ste B, Rexburg, ID 83440 Phone: 208-534-7001 | |
Cody Lane Castellaw, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-359-9570 | |
Anthony Humphries, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1 Professional Plz, Rexburg, ID 83440 Phone: 208-359-2500 Fax: 208-359-2502 | |
Morgan Jesse Ricks, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 36 Winn Dr Ste 100, Rexburg, ID 83440 Phone: 208-356-0174 Fax: 208-356-0176 | |
George Garald Griffeth, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 450 E Main St, Rexburg, ID 83440 Phone: 208-359-6532 |